What is it?

Multiple myeloma is a cancer of white blood cells, called plasma cells. Plasma cells belong to the immune system and are usually found in the lymphatic system. These cells produce proteins called antibodies, which help attack infections. In multiple myeloma, there is rapid and abnormal formation of plasma cells, which fill the bone marrow and interfere with the formation of normal blood cells. Additionally, the cancerous plasma cells produce a large amount of abnormal antibodies, which are ineffective against infections and can aggregate and damage tissues and organs (especially the kidneys). Plasma cells also tend to accumulate in the bones and cause lesions that make the bones fragile. Destruction of the bones can cause dangerous electrolyte disturbances.
Over production (proliferation) of plasma cell does not immediately cause multiple myeloma. Earlier stages include diseases called MGUS (monoclonal gammopathy of undetermined significance) and smoldering myeloma, which are a-symptomatic conditions that do not necessarily require treatment, but can precede the onset of multiple myeloma.

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Additional names

This group contains additional names:
- Plasma Cell Leukemia

Signs & symptoms

Early stages of multiple myeloma may be a-symptomatic. As the disease progresses, signs and symptoms may occur, including bone pain (especially lower back pain), weakness, frequent infections, pallor, constipation, frequent urination, excessive thirst, muscle weakness or numbness in the legs or feet.

Diagnosis

Diagnosis process of multiple myeloma begins with a doctor's examination. Next, the following tests and procedures may be used:
- blood tests, including blood count, blood chemistry studies, and tests that look for abnormal proteins produced by myeloma cells.
- urine test, done as a single sample or a twenty-four-hour urine colleting test.
- Bone marrow test, in which a sample of bone marrow is taken using a needle inserted into the hipbone or another bone.
- Tests to identify the type of the overproduced antibodies, called protein electrophoresis and Immunofixation.
- Imaging tests, such as CT or PET-CT.

Treatment

There are different types of treatment for patients with multiple myeloma, some designed to slow the progression of the disease and some are used to improve symptoms and prevent complications.
Treatment to slow the progression of the disease may include:
- Chemotherapy - treatment that kills quickly growing cells.
- Targeted therapy - treatment that target cancer cells specifically.
- Immunotherapy - treatment that activate the immune system to fight cancer cells.
- Radiation therapy - treatment that uses high-energy x-rays to kill cancer cells.
- Bone marrow transplant - treatment in which healthy marrow from a donor is transplanted and create new healthy blood cells instead of the cancerous cells.
Treatment to ease symptoms or prevent complications may address the following issues:
- Relief in bone pain can be achieved using pain medications or local radiation. Future fractures can be prevented by taking bone-strengthening medications called Bisphosphonates.
- Relief in weakness, usually caused by anemia, can be achieved using drugs that increase the red blood cell production.
- Frequent infections can be partially prevented by getting vaccinated against flu and pneumonia.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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